UCA Motor Claim Comprehensive &TP Form
Request Details
Created By
CLAIMS-HANI
Claim Status
2019
Time Stored
5:38 PM
Document Handle
320081
Date Stored
03/11/2019
The date value should be of the format: dd/MM/yyyy.
delete status
Claim Information
Claim #
*
95\1\101566\2019
Policy Class
MOTOR PRIVATE
Registration Date
The date value should be of the format: dd/MM/yyyy.
Intimation Date
03/11/2019
The date value should be of the format: dd/MM/yyyy.
Policy #
95\1\75478\2018
Policy Branch
UCA WEB
Accident Date
17/05/2019
The date value should be of the format: dd/MM/yyyy.
User Web Branch
1
Policy Type
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THIRD PARTY
UW Year
2018
Najem case number
JD170519359
Client
RETAIL - WESTERN ZONE 3
Insured
عبدالله بن ظافر بن ثواب السبيعي
Claim Status
CLAIM WAITING TO CLOSED
Nature of Loss
COLLISION / OVERTURNING
At Fault
AT FAULT
Responsibility%
100
Violation Reason
لا يحمل رخصة قيادة
Legal Case
TRAFFIC VIOLATION
Loss Place
MARWAH
AMAN User
HANI ABDULAZEEZ FURAIJI AL KHITHABI
Legal Reason
لا يحمل رخصة قيادة
Remarks for Claim Information
-
Claim Note
Vehicle Details
Vehicle Serial
1
Make
FORD
Registration No
أ ب س 6662
Vehicle Value
0.00
Vehicle Owner
عبدالله بن ظافر بن ثواب السبيعي
Year of Make
2008
Custom ID
0
Chassis No
2MEFM74W78X614142
Sequence No
89083800
Type of body
SEDAN
Model
GRAND MARQUIS
Excess
0
Description
Personal Information
License No
1114924069
Mobile No
566001949
Driver Name
OTHER (DRIVER/FRIEND/ETC)
Age
17
TP/OWN Details
Claimant Type
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1
TP/OWN Year of Make
2010
Driver License Number
TP/OWN Type of Body
SEDAN
TP/OWN Estimate
0
TP/OWN Status
2
TP/OD name
عايض ظافر ثواب السبيعي
TP/OWN Sequence No
0
TP/OWN Chassis No
19890
TP/OWN TP Responsibility
0
TP/OWN AMAN User
HANI ABDULAZEEZ FURAIJI AL KHITHABI
TP Status
CLOESED
TP/OWN Make
FORD
TP/OWN Registration No
ب ق ي 1244
Contact Phone
0557911184
Claimant ID
1052819917
Finance Details
Remarks
Finance Information
Finance Information
Payment Voucher
Payment Voucher Type
Is Check Generated
Check #
FIN- Date
Payable Amount
DC VOUCHER
DC VOUCHER TYPE
Reserve Amount
Payment Voucher
3835/2019
Payment Voucher Type
PAYMENT VOUCHER
Is Check Generated
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NO
Check #
0
FIN- Date
13/11/2019
The date value should be of the format: dd/MM/yyyy.
Payable Amount
0
DC VOUCHER
5078/2019
DC VOUCHER TYPE
CN (CLAIM)
Reserve Amount
0
Fraud Selection
Fraud Suspection
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Fraud Status
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Fraud Closing Reason
Requested By
Requested Step
Re estimate Details Info
Re-estimate Status
Re-estimate Details
Re-estimate Details
Re-estimate Serial
Re-estimate Evaluation Date
Estimate Type
Estimate Type code
Re-estimate Est. Value
Re-estimate Paid
Re-estimate O/s
Re-estimate AMAN User
Re-estimate Serial
1
Re-estimate Evaluation Date
03/11/2019
The date value should be of the format: dd/MM/yyyy.
Estimate Type
38 - NAJM FEE - ACCIDENT SURVEY
Estimate Type code
38
Re-estimate Est. Value
280
Re-estimate Paid
280
Re-estimate O/s
0
Re-estimate AMAN User
CLAIMS-HANI
Re-estimate Serial
2
Re-estimate Evaluation Date
03/11/2019
The date value should be of the format: dd/MM/yyyy.
Estimate Type
2 - PROPERTY DAMAGE - TP VEHICLES
Estimate Type code
2
Re-estimate Est. Value
8386
Re-estimate Paid
8386
Re-estimate O/s
0
Re-estimate AMAN User
CLAIMS-HANI
Pymenrts Details
Payment Status
Payments
Payments
Payment Type
Payment No
Net Payment
Payment Date
Payment Year
Payee Name
Payment AMAN User
Payment Credit Note
Payment Status
Payment Type
26
Payment No
5144
Net Payment
280
Payment Date
03/11/2019
The date value should be of the format: dd/MM/yyyy.
Payment Year
2019
Payee Name
AL NAJM FOR INSURANCE SERVICES
Payment AMAN User
HANI ABDULAZEEZ FURAIJI AL KHITHABI
Payment Credit Note
5031
Payment Status
APPROVED
Payment Type
23
Payment No
5171
Net Payment
8386
Payment Date
06/11/2019
The date value should be of the format: dd/MM/yyyy.
Payment Year
2019
Payee Name
عايض ظافر ثواب السبيعي
Payment AMAN User
ASHRAF IBRAHIM AL AMRY
Payment Credit Note
5078
Payment Status
APPROVED
Total Amount
8386
Re-estimate Recovery
Re-estimate Recovery
Re- estimate Serial Recovery
Re- estimate Evaluation Date Recovery
Re- estimate Type Recovery
Re- estimate Type code Recovery
Re- estimate Est.value Recovery
Re- estimate paid Recovery
Re- estimate O/S Recovery
Re- estimate AMAN User Recovery
Recovery & Salvage info
Re-estimate Recovery Status
Recovery V3
Recovery V3
Recovery Amount UCA1
RecoveryType
UCA-Recovery Type Code
Recovery AMAN User
Recovery For
Recovery From
Recovery No
Recovery Year
Recovey Date
Recovey Name
Debit Note
Salvage Information
Note
Vehicle Information
خطاب التنازل
كشف مخالفات
أصل الإستمارة
سجل تجاري للشركات
مفتاح السيارة
إسم الحوش
Surveyors Information
City
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WorkShopName
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Survey Name
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Surveyors Note
Approval Page
Approval Page
Approval Name
Approval decision
Approval date
Approval Name
HANI ABDUL AZIZ AL KHITTABI
Approval decision
CLAIM REGISTERED
Approval date
05/11/2019 02:16:54 PM
The date & time value should be of the format: dd/MM/yyyy h:mm:ss tt.
Approval Name
ASHRAF IBRAHIM AL AMRY
Approval decision
PAYMENT REGISTERED
Approval date
06/11/2019 10:55:50 AM
The date & time value should be of the format: dd/MM/yyyy h:mm:ss tt.
Approval Name
RAMI JAMMAN SAEED ALZAHANI
Approval decision
APPROVED
Approval date
07/11/2019 10:40:44 AM
The date & time value should be of the format: dd/MM/yyyy h:mm:ss tt.
Approval Name
AHMED ALI HAZAZI
Approval decision
APPROVED
Approval date
07/11/2019 01:23:51 PM
The date & time value should be of the format: dd/MM/yyyy h:mm:ss tt.
Approval Name
ASHRAF IBRAHIM AL AMRY
Approval decision
PAYMENT POSTED
Approval date
12/11/2019 01:35:50 PM
The date & time value should be of the format: dd/MM/yyyy h:mm:ss tt.
Approval Name
WALEED KHATEEB
Approval decision
APPROVED
Approval date
13/11/2019 07:49:41 AM
The date & time value should be of the format: dd/MM/yyyy h:mm:ss tt.
Approval Name
ADEL OSMAN
Approval decision
PAYMENT VOUCHER ISSUED
Approval date
17/11/2019 12:25:49 PM
The date & time value should be of the format: dd/MM/yyyy h:mm:ss tt.
Approval Name
BANDAR SALIM SALLOOM
Approval decision
SCANED DISCHARGE & CHECK
Approval date
20/11/2019 08:58:54 AM
The date & time value should be of the format: dd/MM/yyyy h:mm:ss tt.
Approval Name
BANDAR SALIM SALLOOM
Approval decision
CLAIM CLOSED
Approval date
20/11/2019 09:20:37 AM
The date & time value should be of the format: dd/MM/yyyy h:mm:ss tt.